National survey on critical values reporting in a cohort of Italian laboratories

Background: Critical values' reporting is an essential requisite for clinical laboratories. Local policies were investigated within an indicative cohort of Italian laboratories to monitor the situation and establish a performance benchmark. Methods: A five-point questionnaire was administered to 150 laboratory specialists attending the SIMEL (Italian Society of Laboratory Medicine) National Meeting in June 2006. Results: A total of 107 questionnaires (71.3%) were returned with a 100% individual question response rate. Only 55% of the participants acknowledge critical values reporting as an essential practice, 80% admit that a comprehensive list of critical values is unavailable in the laboratory and 4% do not promptly communicate critical values. The list of critical values is variable among laboratories, ranging from none to 20 analytes included. The requesting physician or his/her office staff receives the great majority (97%) of notifications by telephone for outpatients. Critical values for inpatients are notified directly by telephone (81%) and in a minority of cases by either fax or computer (19%). In the inpatient setting, the information is notified to physicians (77%), nurses (15%) or other health-care staff in the clinic (8%). It was found that 49% of the participants adopt a standard (digital or written) policy for routine recording of notifications; in 32% of the cases the registration is left to individual attitudes, whereas in 20% of the cases the notification is not recorded. No laboratory has yet adopted a read-back verification of the complete test result by the person receiving the information. Conclusions: The importance of critical value reporting is still poorly recognized in Italy and uniform or internationally accredited practices for communication and recording are not currently implemented.